Healthcare Provider Details

I. General information

NPI: 1194149500
Provider Name (Legal Business Name): HOBOKEN UMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 CLINTON ST
HOBOKEN NJ
07030-2502
US

IV. Provider business mailing address

308 WILLOW AVE
HOBOKEN NJ
07030-3808
US

V. Phone/Fax

Practice location:
  • Phone: 201-418-2304
  • Fax:
Mailing address:
  • Phone: 201-418-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: BRUCE M BORZON
Title or Position: DIRECTOR, REVENUE CYCLE
Credential:
Phone: 201-418-2304